A Data-Driven Intervention to Reduce Intensity and Variation of ED Opioid Prescribing

With the opioid epidemic ongoing, multiple groups have developed recommendations for curtailing opioid prescribing, but little is known about methods to influence practice change among individual providers. A critical missing link is an understanding of how provider self perception of opioid prescribing varies from actual prescribing practices and how this gap may affect guideline adherence.This was a prospective, multicenter, randomized trial in which all attending physicians, residents, and advanced practice providers at four EDs were randomly assigned to either implementation of a clinical practice guideline (CPG) alone or CPG plus a brief, data driven intervention during which providers were asked to self identify their perceived opioid prescribing in comparison to their peers and then given their actual data. The primary outcome was the change in proportion of patients discharged by each provider with an opioid prescription at six and twelve months. 

Supplement

Publication Date: 
2017
Hospital: 
University of Massachusetts System (UMass Memorial Health Care)
Toolkit Category: 
Clinician Initial Evaluation
Disposition Decision
Exit from ED
Clinical Areas Affected: 
Emergency Department
Staff Involved: 
Administrators
Communications
ED Staff
Nurses
Pharmacists
Physicians
Social Workers/Case Managers
Toxicologists